General Anesthesia Combined with Epidural Anesthesia in Upper Abdominal Surgery

Objective To evaluate the feasibility and efficacy of general anesthesia combined with epidural anesthesia in upper abdominal surgery.Methods Forty patients with ASA grade Ⅰ to Ⅱ scheduled for elective upper abdominal surgery,were randomly divided into two groups:GE group(general anesthesia combined with epidural anesthesia)and G group(general anesthesia).The methods of inducement and maintain of general anesthesia were same in both group.In both groups the general anesthesia was induced with intravenous fentanyl 4 μg/kg,propofol 1-2 mg/kg and vecuronium 0.1 mg/kg,and was maintained with intravenous infusion of propofol 3-5 mg.kg.h and intermittent bolus of vecuronium,fentanyl and/or inhalation of 0.5%-1.5% isoflurane.The patients in GE group were punctured into epidural space though T8-9 intervertebral space,and the duct was inserted towards head side.Fist dose 1% lidocaine and 0.375% ropivacaine was infused into the epidural space after test dose anesthesia plan.The anesthesia plan was under T4 level.Systolic blood pressure(SBP),Diastolic blood pressure(DBP),Mean artery pressure(MAP),Heart rate(HR),general anesthesia drug dosage,time of postoperative revival and postoperative revival were recorded.Results In GE group,the increase of SBP,DBP,MAP and HR at the time of skin incision and after tracheal extubation was significantly lower than those in G group(P0.01),while the postoperative restlessness and general anesthesia dosage were lower than those in G group(P0.01),the postoperative recovery time of GE group was also shorter(P0.01).Conclusion General anesthesia combined with epidural anesthesia can stabilize the hemodynamics,endocrine disturbance as well as postoperative recovery time,reduce the stress to the surgery,and is more effectively and safely employed in upper abdominal surgery.